Monday, March 26, 2012

Things you need to know about an open ankle dislocation, bleeding and the media

Joba Chamberlain, a pitcher for the New York Yankees, suffered an open dislocation of his right ankle a few days ago. He was playing with his son at an indoor children’s gym. Exactly how he was injured is not clear, but it appears he was on a trampoline when it happened. Also not clear is the extent of his injury. We know the injury involved open skin and bleeding. Whether a fracture occurred was not mentioned at first. He underwent surgery immediately to control the bleeding, debride and close the wound and reduce the dislocation.

Some accounts of the injury reported that Chamberlain suffered “life-threatening” bleeding at the scene.

Lesson #1

No one with an extremity injury should ever “bleed out.” For many years, it has been widely known in medical circles that just about all external bleeding can be controlled by direct pressure on the bleeding site.

If direct pressure fails, a tourniquet should be applied. Yes, that’s right—a tourniquet. Long thought to be harmful, tourniquets have made a full comeback and are now considered a first-line method of controlling hemorrhage. [See research here.]

In fact, every soldier in the US Army is issued a personal first-aid kit containing two Combat Application Tourniquets® which can be employed with one hand.

Lesson #2

Depending on the exact nature of the injury that Chamberlain suffered, his prognosis varies from possibly returning to baseball late this season to never playing baseball again. The lesson here is not to speculate until all the information is available. That did not stopping various media outlets from contacting “experts” who weighed in with opinions about Chamberlain’s future.

The latest news is that no bones were broken and if he does not develop an infection [the risk is higher because the dislocation was “open”], he could pitch as early as July [New York Times] or not at all this season [CBS New York]. He was released from the hospital on March 25th, 3 days after the injury occurred.

Lesson #3

The New York tabloid newspapers are every bit as sleazy as their English counterparts. A column in the New York Daily News equates Chamberlain’s injury to that of a former Yankee prospect Brien Taylor whose pitching shoulder was injured in a fight and who recently was arrested for alleged drug dealing. Playing with one’s 5-year-old son is not the same as brawling with someone.

Chamberlain suffered a severe injury. Can we cut him a little slack please?


George said...

What always gets me in media accounts of injuries is when a fracture is ascribed to a joint. Fractures apply to bones, dislocations to joints. One cannot "fracture" their ankle, but one can dislocate it. A "fractured ankle" would be a fracture of the tibia, fibula, and/or talus. I might come across as splitting hairs on this issue, but simple accurate descriptions would help the general public's health literacy. Of course, professional teams don't help matters with vague releases to the press. Of notorious note are NHL injury reports that list injuries two ways: (1) upper body injury, and (2) lower body injury.

Skeptical Scalpel said...


Those are excellent points. I agree that the NHL's policy is ridiculous. Why not just say, "He's hurt"?

George said...

NHL clubs will claim they are purposely vague in many injury reports so as to avoid opponents going after a player's injury site once he returns to the ice. While there may be some truth to this, it doesn't say much for professional hockey. Of course, professional sports has nothing to do with health anyways.

Skeptical Scalpel said...

After hearing about the NFL's "bounty" scandal, I guess the NHL's policy makes more sense.

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